Staffordshire and Stoke-on-Trent Safeguarding Adults Partnership Inter-agency Adult Protection ...

168 Pages·2012·0.94 MB·English

Staffordshire and
Stoke-on-Trent
Safeguarding Adults
Partnership

Inter-agency
Adult Protection
Procedures

September 2010
Staffordshire and Stoke-on-Trent Inter-agency Adult Protection Procedures
CONTENTS

Section Title Page
number
1 Introduction 5
2 Policy Statement 6
Partnership Commitment 6
Information Sharing Commitment 6
Values 7
3 Definitions 11
4 Process Terms 15
Investigation Procedure Flowchart 17
5 Roles and Responsibilities 18
6 Recognising Abuse 24
Physical Abuse 24
Sexual Abuse 25
Emotional Abuse 25
Financial Abuse 26
Neglect 26
Discriminatory Abuse 27
Institutional Abuse 27
7 Risk Factors 28
8 Reporting Abuse 29
What to do when abuse is disclosed by a vulnerable 30
adult
Concerns about employees volunteers or adult 30
placement carers
Whistleblowing and confidentiality for referrers 31
Members of the public who wish to make anonymous 31
referrals
Adult Protection Referral Threshold Flowchart 32
9 Guide to Referrals 33
10 Receiving and Managing Referrals 35
Historic Abuse 35
Situations where an investigation is not required 35
Immediate Actions 36
Alleged abuser(s) who is (are) Vulnerable Adults 36
Assessing the risk of harm 36
Levels of risk of harm 38
Assessment of level of risk of harm 38
Child Protection Referrals 39
Young People in Transition 39
Domestic Abuse/Domestic Violence 40
Multi-agency Public Protection Arrangements (MAPPA) 41
Health and Safety Investigations 42
Doorstep Crime 42
Investigation Procedure Detailed Flowchart 43
11. Strategy Discussions 44

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Staffordshire and Stoke-on-Trent Inter-agency Adult Protection Procedures
Section Title Page
number
Who should be involved in a Strategy Discussion? 44
Allocating Investigating Workers and forming the 46
Investigation Team
Initial Contact with Vulnerable Adult 46
Resolving disagreements 46
Referrals to the Independent Safeguarding Authority 47
(ISA)
Terminating an Investigation at the Strategy Discussion 48
stage
12 Investigations 49
Responsibility for co-ordination of investigation 49
Types of Investigation 49
The Role of the Investigating Social Care/CMHT 51
worker
Initial Contact with vulnerable adult 52
Criminal Investigation Interviews with the vulnerable 52
adult
Interviews with the Vulnerable Adult where no criminal 53
investigation is taking place
Interviews with Alleged Abusers 55
Interviewing Carers and Relatives 56
Interviewing Other Witnesses 56
Documentary Evidence 56
Visits to key places 57
13 Medical Examinations 58
Photography 58
14 Statutory Assessment of Vulnerable Adults 60
Community Care Assessments 60
Carers Assessments 60
Assessment under the Mental Health Act 1983 60
Assessment of Mental Capacity 60
15 Investigating Worker's Reports 68
16 Investigation Review Meetings 69
Agenda and Discussion 71
17 Outcomes Conferences 74
18 The Safeguarding Review 77
19 Large Scale Investigations 78
Large Scale Investigation Flowchart 85
20 Representations and Appeals 86
21 Standard Agendas 89
Investigation Review 90
Outcomes Conference 91
Safeguarding Review 92
LSI Review 93
LSI Outcomes Conference 95
22 Documentation 96
Adult Protection Referral (AP1) 96

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Staffordshire and Stoke-on-Trent Inter-agency Adult Protection Procedures
Section Title Page
number
Adult Protection Closure Form (AP2) 101
Record of Strategy Discussion 104
Investigating Worker Report Proforma 110
Summary of Initial Contact with vulnerable adult 112
Summary of discussion with alleged abuser 115
Summary of discussion with alleged abuser (if 117
vulnerable adult)
Summary of discussion with alleged abuser (if 119
partner/family)
Record of Investigation Review Meeting 121
Record of Outcomes Conference 127
LSI Strategy Discussion Record 133
Suspension of Contract Decision Form 138
LSI Investigation Review Meeting 139
LSI Investigation Outcomes Conference 146
23 Standard Letters 150
24 Legislative Guidance 153
25 Body Maps 167

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Staffordshire and Stoke-on-Trent Inter-agency Adult Protection Procedures
1. INTRODUCTION

Arrangements for safeguarding vulnerable adults are overseen by the
Staffordshire and Stoke-on-Trent Adult Safeguarding Partnership, which brings
together local agencies to promote an inter-agency approach to address all forms
of abuse.

The principles, aims and objectives of the Staffordshire and Stoke-on-Trent
Safeguarding Adults Partnership are set out in the Staffordshire and Stoke-on-
Trent Adult Safeguarding Partnership Safeguarding Strategy.

These Adult Protection Procedures replace the Safeguarding Vulnerable Adults
in Staffordshire and Stoke-on-Trent Policy and Procedures (October 2007); they
describe the inter-agency response to the abuse of vulnerable adults in
Staffordshire and Stoke-on-Trent. As an agreed inter-agency procedure full
compliance is required from all staff in all agencies including social care, criminal
justice, health or housing, or other staff/volunteers who are in contact with
vulnerable adults.

These procedures specifically relate to issues of abuse and exploitation and are
not invoked simply as a response to a perception of ‘vulnerability’.

The key changes to previous procedures can be summarised as follows:

• A clearer focus on putting the vulnerable adult at the centre of the
investigation process.
• A greater emphasis on the need to assess mental capacity and apply
the principles of the Mental Capacity Act 2005.
• A clearer framework for the assessment of the risk of harm in each
case and for reviewing this as investigations proceed.
• Documentation which more explicitly supports the investigation
process.
• Some changes in terminology where this was previously seen as
confusing or unhelpful.

These Procedures will be reviewed in April 2011 and annually thereafter to
ensure that they reflect current legislation and guidance.

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Staffordshire and Stoke-on-Trent Inter-agency Adult Protection Procedures
2. POLICY STATEMENT

Partnership Commitment

Safeguarding vulnerable adults and promoting their well being, personal dignity
and respect requires effective co-operation amongst all those who work with, or
who are involved with, adults in Staffordshire and Stoke.

The establishment of Staffordshire and Stoke Adult Safeguarding Partnership
(SSASP), duly made under the provisions of the National Health Service Act
2006, enables statutory agencies to work in partnership to ensure that
appropriate policies, procedures and practices are in place and implemented
locally.

The Executive Board has the responsibility to give strategic direction and to
ensure that the resources are in place to support the Operational Board and
deliver the strategy and annual business plan.

By participating in this partnership, all are stating their intention to fulfil their
obligations as identified in the Terms of Reference. Partnership obligations
include the following: Committing representatives to participate, in Partnership
meetings:
• Promoting the work of the Partnership including compliance with both
the Adult Protection Policy and the Mental Capacity Act.
• Ensuring that the appropriate “rank” of staff attend the relevant
Partnership meetings.
• Actively participating during all Partnership meetings.
• Ensuring staff attend learning development opportunities as laid out in
this strategy.
• Providing information that assists in making the governance
arrangements for the Partnership effective.

Information Sharing Commitment

Information sharing is key to delivering a better, more efficient public service that
is coordinated around the needs of the individual.

Information will be shared in all areas of Safeguarding and Protection for the
purpose of:

• Operational and strategic working together
• Wider partnerships
• The work of the Partnership
• Data, audit and performance information
• Learning lessons
• Identifying best or effective practice

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Staffordshire and Stoke-on-Trent Inter-agency Adult Protection Procedures
Sharing information in a timely manner is essential in early recognition and
intervention in cases of actual and potential abuse. It is important for the wider
safeguarding strategy of promoting and maintaining the health and wellbeing of
all vulnerable adults.

All individuals (whether paid or voluntary) and organisations are committed to
making appropriate Adult Protection referrals as soon as the abuse of a
vulnerable adult is recognised.

Each agency represented within the Partnership agrees to take positive action
where partners, staff and others are found to have withheld information that could
put a vulnerable adult at risk.

The Staffordshire and Stoke Safeguarding Adult Partnership recognises the
importance of information sharing in order to protect vulnerable adults. Any
information shared in this context will be done in accordance with the Inter-
Agency Adult Protection Procedure.

Values

The SSASP recognises that Safeguarding includes a wide range of activities that
will be preventative and which will support vulnerable adults to ensure their own
protection as well as establishing care provision that combines the need for
personalised services with that of ensuring that they also promote protection from
abuse.

The SSASP is committed to working in accordance with values stated in key
areas of legislation, national guidance and local Policy documents. The values
outlined below, will be reflected in the Safeguarding Strategy and supporting
Business Plan, the Adult Protection Procedure and in the contracts for all Health
and Social Care related services.

All services to vulnerable adults are provided in line with the requirements of the
Human Rights Act 1998 citing the articles of the European Convention of Human
Rights. Of particular relevance are:

Article 2 - Right to life;
Article 3 - Prohibition of torture or inhuman or degrading treatment or
punishment;
Article 4 - Prohibition of slavery and forced labour;
Article 5 - Right to liberty and security of person;
Article 6 - Right to a fair trial;
Article 7 - No punishment without law;
Article 8 - Right to respect for private and family life;
Article 9 - Freedom of thought, conscience and religion;
Article 10 - Freedom of expression;
Article 11 - Freedom of assembly and association;
Article 12 - Right to marry;
Article 14 - Prohibition of discrimination;
Article 17 - Prohibition of abuse of rights.

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Staffordshire and Stoke-on-Trent Inter-agency Adult Protection Procedures
The Mental Capacity Act 2005 sets out 5 statutory principles that must be
adhered to in relation to any act relating to issues of mental capacity:

• A person must be assumed to have capacity unless it is established
that they lack capacity.
• A person is not to be treated as unable to make a decision unless all
practicable steps to do so have been taken without success.
• A person is not to be treated as unable to make a decision merely
because they make an unwise decision.
• An act done, or decision made, under this Act for or on behalf of a
person who lacks capacity must be done, or made, in their best
interests.
• Before the act is done, or the decision is made, regard must be had to
whether the purpose for which it is needed can be as effectively
achieved in a way that is less restrictive of the person’s rights and
freedom of action.

The Partnership also endorses the Dignity Challenge by accepting the following
values as part of its strategy:

• Have a zero tolerance of all forms of abuse.
• Provide support to people with the same respect paid workers would
want for themselves.
• Treat each person as an individual by offering a personalised service.
• Enable people to maintain the maximum possible level of
independence, choice and control.
• Listen and support people to express their needs and wants.
• Respect people’s right to privacy.
• Ensure people feel able to complain without fear of retribution.
• Engage with family members and carers as care partners.
• Assist people to maintain confidence and a positive self-esteem.
• Act to alleviate people’s loneliness and isolation.

No Secrets (2000) identifies the following guiding principles for work in Adult
Protection:

• Actively work together within an inter-agency framework based on
the guidance in Section 3 [national and local];
• Actively promote the empowerment and well-being of vulnerable
adults through the services they provide;
• Act in a way which supports the rights of the individual to lead an
independent life based on self determination and personal choice;
• Recognise people who are unable to take their own decisions
and/or to protect themselves, their assets and bodily integrity;
• Recognise that the right to self-determination can involve risk and
ensure that such risk is recognised and understood by all concerned
and minimised whenever possible (there should be an open discussion
between the individual and the agencies about the risks involved to
him or her);

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Staffordshire and Stoke-on-Trent Inter-agency Adult Protection Procedures
• Ensure the safety of vulnerable adults by integrating strategies,
policies and services relevant to abuse within the framework of the
NHS and Community Care Act 1990, the Mental Health Act 1983, the
Public Interest Disclosure Act 1998 and the Registered Homes Act
1984 [since replaced by the Care Standards Act 2000 and
subsequently by the Health and Social Care Act 2008].
• Ensure that when the right to an independent lifestyle and choice
is at risk the individual concerned receives appropriate help,
including advice, protection and support from relevant agencies; and
• Ensure that the law and statutory requirements are known and
used appropriately so that vulnerable adults receive the protection of
the law and access to the judicial process.

Based upon the above requirements the Inter-Agency Adult Protection Procedure
(April 2010) sets out the agreed principles for the work of the Board and its
partners:

• The human and civil rights of vulnerable adults in Staffordshire and
Stoke-on-Trent will be promoted and protected.
• The independence, well being and choices of vulnerable adults will be
actively promoted.
• Partner agencies will work co-operatively with each other and with other
agencies to recognise report, investigate and prevent the abuse of
vulnerable adults. Defensible decision-making that involves inter-
agency liaison, communication and information sharing will underpin
investigative practice.
• Allegations of abuse will be co-ordinated by the local agencies serving
the area where the abuse is alleged to have taken place.
• Partner agencies will not compromise or obstruct any Adult Protection
Investigation by statutory agencies (e.g. Police, CQC, Social Services
etc.) through their own inappropriate or premature investigations.
• Vulnerable adults will be assumed to have capacity except where it is
established that this is not the case. Where a vulnerable adult lacks the
mental capacity to make decisions assistance will be offered on a multi-
disciplinary basis to achieve his/her best interests.
• A vulnerable adult who has mental capacity has the right to take risks.
Services will recognise and accept that an individual has the right to
self-determination that may involve a degree of risk. Agencies will
undertake and record risk assessments to monitor this.
• Vulnerable adults have a right to receive the protection of the law, have
access to justice and be appropriately supported through the criminal
justice process. Services will provide suitable advice and support to
enable this to occur.
• Vulnerable adults’ views will be considered and where possible they will
be fully involved in actions taken under the procedures. A vulnerable
adult has the right to an advocate to assist them in this process.
• All investigations and assessments of vulnerable adult abuse will take
account of people’s ethnic origins, gender, sexuality, age, disability,

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Staffordshire and Stoke-on-Trent Inter-agency Adult Protection Procedures
religious and cultural background and be carried out in an appropriate
setting, manner and language.
• When intervention is necessary to reduce risk to a vulnerable adult,
account will be taken of the disruption to the service user and every
effort will be made to minimise this and to keep it in proportion to the
identified risks.
• Confidentiality relating to vulnerable adults will be ensured when it is
practicable and personal information will only be shared with other
agencies with the permission of the individual concerned or in line with
what is permitted by the law and local policy or protocols.
• Partner agencies will work to promote awareness and understanding of
the law, guidance and new initiatives relating to safeguarding vulnerable
adults.

This Policy Statement is taken from the Staffordshire and Stoke-on-Trent Adult
Safeguarding Partnership’s Safeguarding Strategy (2010)

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